In 1856, before the state of Washington was even a state, five Catholic nuns arrived in the area of Fort Vancouver, Washington, on the banks of the Columbia River from Montreal. Once established, Mother Joseph of the Sacred Heart and four other Sisters of Providence, served the needs of orphans and the elderly. They opened hospitals, schools and orphanages across the Northwest. This was the humble beginnings of what would become Providence St. Joseph Health.
Providence St. Joseph Health, the third largest not-for-profit health system in the U.S., now has over 50 hospitals and 106,000 employees.
As a part of this large health system, Providence Health and Services is the largest health care provider in Washington state, according to the health care systems’ website. Providence Regional Medical Center in Everett, Washington is part of both systems. The hospital opened its doors in 1905. It has the 10th busiest single-location emergency department in the nation. The city of Everett, Washington, with a population of 103,000 sits 25 miles north of Seattle.
Taking on the equipment maintenance and repair duties is the clinical engineering team at Providence.
“The department began in 1991 and has grown with the medical center in reputation and volume,” says Jaran Friday, supervisor of clinical engineering. The department is led by Bud McIrvin, director of facilities and clinical engineering. Tricia Nelson is facilities coordinator.
The team’s biomeds include April Winters, Nick Van Veen, Dan Price, David Francisco, Gina Christensen, Akif Cetinkaya, Kirk McGarity, William Pickett and Eric Le. The team also includes imaging service professionals – Jeff Funke, Jerry Harju and Tom Markham.
“We cover most specialties in-house including X-ray, MRI, CT, CVL, anesthesia, respiratory, lab, SPD and surgery,” Friday says.
“Technicians are assigned to primary departments for responsibility and to enhance relationships with clinical departments.”
Friday says that the department maintains and repairs all medical devices and imaging equipment in the hospital as well as for their clinic group. They also provide retail services for their community clinic groups. They also provide equipment consultation to leadership and provide capital information for cost of service ratio(COSR).
The CE group has also realized the shared goals they have with their IT colleagues and have established a relationship to accomplish those shared goals.
“Our CE group has a great relationship with our IT partners. Over the past two to three years, it became apparent that more and more medical devices are connected to IT systems and we needed to solidify the bond between the departments,” Friday says. “There is often a struggle to keep some of our older medical equipment connected to IT systems, as they often use outdated protocols, that force IT and our department to work hard to find safe solutions.”
The CE team also plays a part in determining the need for service contracts.
“Biomed reviews all contracts and works on limiting the amount of coverage if it can be sourced internally as well as partnering with our vendors to maximize uptime with cost efficiency,” Friday says.
Meeting Special Challenges
Apart from their more routine duties, the department has been active in the purchasing arena, helping the hospital to evaluate potential imaging equipment.
The team “recently arranged and hosted a mobile X-ray vendor fair where we had four manufacturers bring in their units for the imaging technologists and other staff to evaluate in advance of a purchase,” Friday says.
The hospital has been growing in volume and acuity over time and did not have an appropriate number of portable X-ray units to cover all the patients, according to Friday.
“Biomed reached out to the leading manufacturers of portable X-ray units and arranged to have them bring their latest units on-site for an evaluation/fair where the hospital staff was able to drive the units around and see the latest technology,” he says. “During this event, they evaluated the different units and were able to ask questions of the different vendors and see which features would help them the most in our environment.” The department also renders retail support to an extended community of health care providers beyond the walls of the hospital.
“In Snohomish County we have a large independent clinic network in addition to our own Providence Medical Group. That clinical group supports the same patients as our hospital, so our biomed group reached out and found a way to support them, with retail biomedical services. In essence, we support and maintain all of their biomedical devices with our hospital-trained biomeds,” Friday says.
The team has also faced down the challenges of integrating devices into their network.
“We also are tasked with connecting more and more medical devices wirelessly to our intranet and keeping them secure,” Friday explains.
“One of the most common problems we face in our department is new technology. We are constantly challenged by new medical devices that integrate with hospital infrastructure. We are working on our final phases of EMR integration and finding new and creative ways to connect medical devices to populate real time physiological data into our EMR,” Friday says.
Another recent problem was helping to design a new CVL room for TAVR (transcatheter aortic valve implantation) procedures. The CE team helped find a way to fit all the equipment needed for those procedures into the surgical suite and remain useable at a moment’s notice.
“TAVR is a new procedure to our hospital and required an enormous amount of equipment to be available in addition to the standard cath lab,” Friday says. “During the procedure, they will often need to rotate between the cath lab equipment to an ultrasonic TEE probe. This requires the cath lab to function as a hybrid OR with full fluoroscopy and ultrasound capabilities, while remaining sterile for the procedures. In addition to this the staff also wanted to have the ability to remotely view the procedures in remote conference rooms.”
Friday says that an effort to keep up with regulatory changes keeps the department busy. One recent change that the department has been navigating is in regards to relocatable power taps (power strips).
“We had to deal with multiple regulatory bodies, who each had a different interpretation of the regulation, and we had to push back with our understanding, which ultimately ended up being what the regulatory bodies surveyed for,” Friday says.
In addition to these projects and challenges, the group has been involved in a capital strategy replacement effort; prioritizing capital needs based on service history and obsolesces.
The active CE team at Providence Regional Medical Center would make the “founding” five Catholic nuns proud today; and with good reason.
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